Stage II. Designing
Selecting focus for a campaign and choosing occupations to facilitate participation in, is based on insights gained during the Initiation phase. This is very important since the focus of the campaign depends on the understanding and interpretation gained. If the understanding is different, then the action taken and facilitated designed may be different too. The design process is ongoing, dynamic and evolves through the initiation, implementation and monitoring and evaluation phases.
Designing an intervention involves:
- a) Applying occupational science and occupational therapy theories that inform the conceptualization of the need
- b) Planning and selecting strategies to meet the individuals’ and group’s needs
- c) Accessing resources necessary to realize the intervention
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a) Applying occupational science and occupational therapy theories that inform the conceptualization of the need
Occupations may be used as a means and as an end. The ideal is to design an intervention that includes elements of applying occupation as both means and ends. The practitioner has to decide on which theories from occupational science and occupational therapy can aid in understanding the focus of intervention.
Examples of useful theories and constructs are:
- Occupational choice (Galvaan, 2010)
- Occupational consciousness (Ramugondo, 2012)
- Occupational potential (Wicks, 2005)
- Occupational injustice (Stadnyk, Townsend, & Wilcock, 2010; Whiteford & Townsend, 2011)
- Occupational possibilities (Rudman, 2010)
- Occupational identity (Rudman & Denhart, 2008)
- Occupational transitions (Jonsson, 2010)
These theories, together with the understanding of how occupations are performed and experienced in the relevant context, are used to shape the design of the intervention. For example, in the Expanding Horizon campaign, the appreciation of the stereotypical categories of occupations performed by adolescents in Lavender Hill, the manner in which they usually engage in occupations and the recognition of the lack of diverse opportunities for occupational engagement, framed the conceptualization of the campaign.
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b) Planning and selecting strategies to meet the needs of individuals and the group’s identified needs
The way that the campaign is designed is informed by the interpretation of constructs such as those listed above, as relevant in the specific context and the particular identified needs. The design phase of a campaign involves discussions about the possible occupations to be engaged in, but should incorporate action. Testing the possibilities through actual participation in occupations is central to this action.
The practitioner also has to decide which strategies would be most effective for promoting participation towards addressing the mutually agreed needs. In addition to the strategy of testing the occupation or parts thereof, other strategies include: engaging with key stakeholders and explore alternate possibilities in this or other communities and introducing ideas and testing the feasibility by evaluating responses from participants.
The process of arranging for the participation in the occupations, requires that the practitioner should give careful attention to the design and structuring of the performance of the occupation. Bearing in mind the understanding gleaned through Initiating phase, the nuances of the way in which participation usually occurs for the individual and group should be incorporated into the way the design is planned. To do this effectively, an activity analysis should be completed in preparing and planning for the various occupations that are to be facilitated in ways that are contextually relevant.
Here it is important to note that the relevance is defined in terms of the need being addresses and the understanding of the context. Relevant occupations do not mean that the occupations should always be in keeping with what is usual in the context. This requires that the participants should access necessary resources using locally available opportunities or seeking accessible opportunities within the local context. In designing the structure of the occupation to be performed, the therapist should consider the occupational profile uncovered during the initiating phase. Most important is that the participants are directly involved in as many aspects of designing the intervention, as appropriate.
This involvement may, for example, be through accessing resources or shaping the occupation selection. Here the practitioner has to consider how to include all the participants in a group, remember that:
- i) It is better to have different people fulfilling different roles, or contributing in ways that draws on their strengths
- ii) Work with individuals on specific needs or with sub-groups is a useful strategy
- iii) Everyone, should have some role, but not everyone has to fulfill the same role.
- iv) Make every contribution count.
- v) Consider the timing of the parts of the campaign or the aspects of the occupation and plan to allow for the processes involved in the performance of an occupation to unfold
During the design, it is important that the aims of promoting social inclusion are foregrounded so that relevant opportunities for advocacy are created. Occupation may be applied as means and as an end or either. In both instances, there should be an opportunity for reflection and dialogue about the assumptions informing beliefs and actions related to performance. The intention is to create awareness about further personal and institutional strengths and areas of growth in relation to the occupational performance. Once initial occupations are participated in, there should be a reflection and then further occupations should be pursued, either as they emerge or as the need for further selection arises.
c) Accessing resources necessary to realize the intervention
Participants together with the practitioner should identify and then draw on a wide range of networks to ensure access to the necessary resources. Resources may be human, financial, time, or opportunities to access occupations and people skilled in specific occupations. Resources that directly or indirectly support the performance of the occupation. The practitioner has to use their knowledge of management to communicate with possible partners. The intentions and strategies employed in the campaign need to be communicated.
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